Permit CITY OF TIGARD MECHANICAL PERMIT
2 COMMUNITY DEVELOPMENT Permit #: MEC2010 -00322
T f G AR ti 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 07/09/2010
Parcel: 2S102BD00701
Jurisdiction: Tigard
Site address: 12785 SW PACIFIC HWY
Subdivision: Lot: 0
Project: Spec Space
Project Description: gas line for roof top unit (under separate permit)
Owner: FEES
THE HOLLAND INC Description Date Amount
109 WEST 17TH STREET Permit Fee 07/09/2010 $69.06
VANCOUVER, WA 98660 12% State Surcharge - Mechanical 07/09/2010 $8.29
PHONE:
Contractor:
STEWART PLUMBING
9000 NE 90TH ST
VANCOUVER, WA 98662
PHONE: 360- 892 -5215
FAX: 360- 892 -5311
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressue: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 0 -3 HP:
Furnaces >= 100K BTU: 3 -15 HP:
Floor Furnaces: 15 -30 HP:
Unit Heaters: 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $77.35
Hoods: Comm Incinerators: Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire /Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: a 41 Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
D ECEIVE 1� l ..
Mechanical Permit Application ` . � � t)llt)1' l lC l t; t) � �
City of Tigard Received permit N• 4 ' ^ ■
° 13125 SW Hall Blvd., Tigard, OR 97223 JUL 0 9 f 10
Date/By: / 9 / 0 �{ .�` — V 1✓ /� 4 v 3a
' C '' Phone: 503.639.4171 Fax: 503.598.1960 Date/By: an Review Other ermt
Inspection Line: 503.639.4175 D h P �G( �Q /Q � /0 62 Ins
T I <.� A It 1) p CITY OF TIGAR �' Date Ready/By: iii See Page 2 for
Internet: www.tigard - or.gov BUILDING DIVISI 0 Notified/Method: - Supplemental Information
TYPE OF WORK • COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction Addition /alteration replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION
Value: $ ,QQ , 0
RESIDENTIAL .EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling I►', ommercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family 1■ Master builder ❑ Other: Description 1 Qty. 1 Ea. 1 Total
. JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning
Job site address:
/.2 .,T.,,.._) ,4.9c tFiC. , y (requires site plan showing placement) 46.75
City /State /ZIP: To Furnace 100,000 BTU (ducts/vents) 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: . eAc a¢ u1r.t_E Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
_ - — - , - Gas fireplace 33.39
�9 L/A/g v72.. ,?()Q/- _ ,P 7 /4-"L// _ Flue vent for water heater or gas
C /�CGe-&� bt , V � Sr— P���i6, . Pt :/T \ fireplace 23.32
/ l Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
Chimney /liner /flue /vent 23.32
❑ PROPERTY OWNER I ❑.TENANT
Other: 23.32
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
- ❑ APPLICANT ❑ CONTACT PERSON - Attic /crawlspace fans 23.32
Other: 23.32 _
Business name: ,...5 7-
... `y,y,4 / .-u,i,,,CfruC, Fuel piping
Contact name: � c_17e1.,JM,d7— $14.15 for first four; $4.03 for each additional
Furnace, etc.
Address: ?WO tiic 977 3T. Gas heat pump
City /State /ZIP: �i cr..169 Wr4 9£84,6 Z. Wall /suspended/unit heater
Water heater
Phone: ( 36o) 23c 2- .5 1,5 Fax:: (36c) F3`t2 - z--St f Fireplace
E -mail: /o.ncc `g , c . cows.'" Range
CONTRACTOR Barbecue
• , Clothes dryer (gas)
Business name: Other: Pdjj f 7ep 14N /7 /
Address: MECHANICAL PERMIT :FEES* ,
City /State /ZIP: Subtotal
permit fee ($90.00) ,! ..g44 .
Phone: ( ) Fax: ( ) Plan review (25% of permit fee) F., o29
CCB lic.: yqG ' State surcharge (12% of permit fee) _= -i
TOTAL PERMIT FEE 14
Tb This permit application expires if a permit is not obtained within 180
Authorized signature: v _ days after it has been accepted as complete.
T 7 / A * Fee methodology set by Tri- County Building Industry Service Board
Print name: Date: '/r/
I:\ Building \Permits\MEC- PermitApp.doc 10/01/09 440- 4617T /02/COM/WEB) / �/
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi- Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to $500.00 Minimum fee $69.06
$500.01 to $5,000.00 $69.06 for the first $500.00 and
$3.07 for each additional $100.00 or
fraction thereof, to and including
$5,000.00.
$5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and
$2.81 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and
$2.54 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and
$2.49 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first $100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
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